Abstract:
BACKGROUND:There is evidence that patients with chronic fatigue syndrome (CFS) have mild hypocortisolism. The clinical significance of this is unclear. We aimed to determine whether hypocortisolism exerted any effect on the response of CFS to cognitive behavioural therapy (CBT). METHOD:We measured 24-h urinary free cortisol (UFC) in 84 patients with Centers for Disease Control and Prevention (CDC)-defined CFS (of whom 64 were free from psychotropic medication) who then received CBT in a specialist, tertiary out-patient clinic as part of their usual clinical care. We also measured salivary cortisol output from 0800 to 2000 h in a subsample of 56 psychotropic medication-free patients. RESULTS:Overall, 39% of patients responded to CBT after 6 months of treatment. Lower 24-h UFC output was associated with a poorer response to CBT but only in psychotropic medication-free patients. A flattened diurnal profile of salivary cortisol was also associated with a poor response to CBT. CONCLUSIONS:Low cortisol is of clinical relevance in CFS, as it is associated with a poorer response to CBT. Hypocortisolism could be one of several maintaining factors that interact in the persistence of CFS.
journal_name
Psychol Medjournal_title
Psychological medicineauthors
Roberts AD,Charler ML,Papadopoulos A,Wessely S,Chalder T,Cleare AJdoi
10.1017/S0033291709990390subject
Has Abstractpub_date
2010-03-01 00:00:00pages
515-22issue
3eissn
0033-2917issn
1469-8978pii
S0033291709990390journal_volume
40pub_type
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